Expert AI as a Healthcare Superpower

The last few months have seen dramatic — almost magical — applications of expert generative AI released to the public. But what does this mean for healthcare and bio? Vijay and Marc sat down for a wide-ranging discussion on AI as an additive superpower…for healthcare as well as screenplays, music, and more. Stay Updated: → Find us on Twitter: https://twitter.com/a16z → Find us on LinkedIn: https://www.linkedin.com/company/a16z → Subscribe on your favorite podcast app: https://a16z.simplecast.com/ → Follow our host: https://twitter.com/stephsmithio Please note that the content here is for informational purposes only; should NOT be taken as legal, business, tax, or investment advice or be used to evaluate any investment or security; and is not directed at any investors or potential investors in any a16z fund. For more details please see a16z.com/disclosures.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:01Steph Smith?

  2022 was a year where many of us got to experience firsthand how AI is transforming the creative spheres, from writing to image generation. But those are far from the only arenas for AI's advancing. In this episode, A16Z Bio and Health founding general partner Vijay Pande sits down with A16Z co-founder Marc Andreessen, who infamously wrote his essay "Software is Eating the World" over a decade ago. In this conversation, Mark and Vijay discuss what AI can and cannot do today, but also the tension of where it's advancing and what might stop it. They also explore the rapidly advancing technology with a frame of what it can augment instead of replace, touching on the potential future of doctors, teachers, therapists, and more. I hope you enjoy this fascinating conversation.

• 0:52Speaker 01

  Hello and welcome to BioEats World, a podcast at the intersection of bio, healthcare, and tech. I'm Olivia Webb, the editorial lead for Bio and Health at A16Z.

• 1:07Speaker 01

  I'm very excited to share this episode because it features Bio and Health founding partner Vijay Pande in conversation with A16Z co-founder Marc Andreessen on the topic of expert AI. You can also check out a video version of this podcast on A16Z's YouTube channel and we'll link it in the show notes. In this episode, Mark and Vijay have a lively discussion about the future of expert AI with regard to healthcare, but they also get into self-driving cars, screenplays, music, and the nature of consciousness itself. It's one of our longest episodes to date, but we could have gone longer. As Vijay and Mark discuss, AI has the potential to change many industries. So let's get started.

• 1:49Vijay Pande?

  Hey, I'm Vijay Pande. I'm the founding general partner of the A16Z Bio and Health Fund.

• 1:55Marc Andreessen?

  And I'm Marc Andreessen, co-founder of A16Z.

• 1:59Vijay Pande?

  Mark, thank you so much for joining us.

• 2:00Marc Andreessen?

  Yes, great to be here.

• 2:02Vijay Pande?

  So, you know, you famously wrote about software eating the world. And that was basically, what, 10 plus years ago? And actually, that very much seems to have come to fruition. If you look at all these other industries that software really wasn't so a part of. Software's actually become a dominant part. But actually, this year's been kind of an amazing year for another type of software, for AI. And I'm curious to sort of talk about the arc of what we think is going to happen in the future, based on what we've seen in the past. And, and really how this new technology is going to change everything, much like we've seen software change the last 10 years. I'm curious what you think for just like this year. It's been kind of an amazing year. We always seem like not much happens in any given year, but 2022 seems to have been an amazing year for AI.

• 2:44Marc Andreessen?

  Well, so Vladimir Lenin, yes, once said, there are decades in which nothing happens. And then there are weeks in which decades happen.

• 2:51Vijay Pande?

  Yes.

• 2:52Marc Andreessen?

  And let's not hope that happens politically anymore. But it does happen, you know, in science and technology, it does happen. There are sort of moments where things kind of hit critical mass. And, you know, this, this sort of AI machine learning revolution seems, seems like that's what's happening right now. You know, it's been interesting to watch, you know, it's, it's sort of like, it feels to me at least, it was like, there was like a breakthrough moment in 2012, right? It had to do with images.

• 3:14Vijay Pande?

  Yeah.

• 3:14Marc Andreessen?

  And then there was a lot of work, you know, subsequently that led to, you know, things like the creation of self-driving cars, you know, based on that. And then there was some, it feels like some natural language breakthrough, maybe three years ago.

• 3:23Vijay Pande?

  Yeah.

• 3:23Marc Andreessen?

  And now that's really catalyzed into this, you know, kind of whole thing that we see happening around, you know, GPT and text generation.

• 3:29Vijay Pande?

  Yeah.

• 3:30Marc Andreessen?

  And then, you know, even, even other, other applications, transcription, you know, is getting much better. All of a sudden, speech synthesis is getting much better. And then now you've got this artistic revolution happening with image, image, you know, image creation. And now that video creation is, is, is right next, you know, coming up now really fast.

• 3:45Vijay Pande?

  Yes.

• 3:46Marc Andreessen?

  And so it seems like one of those catalytic moments. And then it's, it's, it's, you know, it's like every week now, there's like, it seems like there's like fundamental breakthroughs, there's research papers, there's product releases coming out. So it seems like a cascading thing. The, the way I think about it as a software person, you know, sort of lifelong, lifelong programmer. Is that they're, you know, basically in the fullest of time, it will appear, I think that there were kind of two different ways to write software. There was the sort of the old Peter Wright software, which is sort of the classic von Neumann machine, you know, deterministic way. And the whole problem with writing software in the old model is like computers are hyper literal.

• 4:17Vijay Pande?

  Yes.

• 4:18Marc Andreessen?

  And so they do exactly what I tell them.

• 4:20Vijay Pande?

  Unfortunately.

• 4:20Marc Andreessen?

  Right. Every time they do something wrong, it's because you have instructed them improperly. And it's your

• 4:25Vijay Pande?

  Yep. Very humbling.

• 4:26Marc Andreessen?

  Experience to learn as a young programmer that everything is your fault. And the machine will just sit and wait for you to fix the problem. Like it's not gonna, it's not gonna do that on its own. But then there's this new, there's this other way to write software. And this has to do with, you know, having, having these, these AI systems and then having training data, training the systems, tweaking the systems and the sort of, you know, capability that that, the way I describe it to kind of normies is that, you know, that sort of unlocks the ability for computers to more and more interact with the real world.

• 4:50Vijay Pande?

  Yes.

• 4:50Marc Andreessen?

  And with the messiness of the real world, right? And the probabilistic nature of the real world.

• 4:54Vijay Pande?

  Yeah, well, it seems almost less like writing software, almost like training some things. Like when I think about machine learning and image recognition, you talked about, it felt like it was almost like training a dog. Right? Like reinforcement learning is like, we'll give treats as it gets better. But there's something different now. It feels like, I don't know, we've gone from like training a dog to recognize a bird versus like a hot dog or hot dog or not hot dog or so on, to actually something where it feels closer like training a person. Or I don't know how you feel. Like when we talk about learning and training and data, like what are we training? What is, where do you think we are in that arc of getting to like eventually how 9,000 and so on?

• 5:28Marc Andreessen?

  Also, I, while this has been happening, you know, you have kids, like I have a, you know, young, young child. So I have a seven year old now. So as this stuff has all been happening, I've been simultaneously training, training now the seven year old.

• 5:39Vijay Pande?

  Yes.

• 5:39Marc Andreessen?

  Yeah. You know, anybody who's had, who's had kids will recognize what, you know, kind of what I'm about to say. But, um, you know, it is really interesting watching little kids. The way I think about it, or at least, at least, at least the little kid I have who's great. Um, it's like, you know, it's like everything for the first, for the first few years, it's like every single thing he did was like a little applied physics experiment, which is like, let's see what happens if I drop this. Let's see what happens if I eat this. Let's see what happens if I do this to daddy.

• 6:03Vijay Pande?

  Yes.

• 6:04Marc Andreessen?

  Right? And see what the response is. And they just run experiment after. And you can see it, you can see it very clearly when they're like learning how to walk. Cause they're like running all these experiments about how to stand up and what to hold on to. And they keep falling over. And then at some point like the

• 6:15Vijay Pande?

  Yeah, little neural network like actually figures it out. It does learn off the way they go, right?

• 6:18Marc Andreessen?

  Yeah.

• 6:19Vijay Pande?

  Um, and so, you know, clearly it's like, it's kind of, you know, it's a little bit eerie. Like you can see that a similar kind of thing happening. You know, like, having said that, like, you know, the, you know, the human brain just like keeps developing. Um, and then, you know, it, it ultimately, you know, it clearly has consciousness, achieves, you know, higher levels of consciousness, achieves higher levels of sort of self-knowledge. You know, reaches the Descartes, you know, kind of, you know, stage where it has self-awareness. Um, you know, clearly is very creative from an early age.

• 6:44Marc Andreessen?

  I'm a little less convinced that the tech, software technologies we have now are like on some linear path towards just like, quote-unquote, AGI.

• 6:50Vijay Pande?

  Yes.

• 6:51Marc Andreessen?

  Quote-unquote, like consciousness, like.

• 6:52Vijay Pande?

  Yes.

• 6:53Marc Andreessen?

  Uh, it's hard for me to believe the consciousness is just simply like emergent from like higher scale neural networks. Like I, I, I, that to me seems like a hand wave.

• 7:00Vijay Pande?

  Yeah.

• 7:01Marc Andreessen?

  Having said that, I have a lot of smart friends who are pretty sure that that's what's gonna happen, so.

• 7:04Vijay Pande?

  Yeah, actually, I feel that way as well. So I want to get to AGI in a bit. I mean, and also we can debate whether consciousness is an illusion, as it is. But, but, uh, where we are now is kind of amazing. Like, can people can take like GPT-3, it can give it SAT exams, can do okay, can like.

• 7:20Marc Andreessen?

  Actually, it can do quite well.

• 7:21Vijay Pande?

  Yeah, yeah, it can do.

• 7:21Marc Andreessen?

  Scores it like the, so the one I saw that scored it like with 1200.

• 7:24Vijay Pande?

  Yeah, yeah, something like that. Yeah, so it's not bad, right? I can do that work.

• 7:28Marc Andreessen?

  That would get you in a lot of.

• 7:29Vijay Pande?

  Yeah, I actually gave it like acid questions like to explain the derivation for the source trial radius. You know, the black hole radius, to write a code for, let's say, eight by eight tic-tac-toe. Like random things that you should never be able to do because it's not just memorizing it, it's generalizing. And it's getting that. But then also it actually seems to have some sort of weird hiccups. And that, uh, actually one thing that it really does not seem to get is humor. You know, um, so I'm kind of curious where you think it's gonna go because before we get to AGI, there are things that an average human can do pretty well that GPT-3 can't. But then there's also what experts can do. And, uh, what I'm very curious about is actually we may get to some of the expert stuff first,

• 8:13Vijay Pande?

  uh, before it can do even something like humor. The irony is that something like humor that we take for granted might actually be really hard. And other areas might be easier.

• 8:22Marc Andreessen?

  Well, the ultimate example of the things it can't do, like it can't like pack your suitcase.

• 8:25Vijay Pande?

  Yeah, yeah.

• 8:26Marc Andreessen?

  Like, there's no robot that will pack your suitcase.

• 8:27Vijay Pande?

  Yeah.

• 8:27Marc Andreessen?

  Like, it will, and if you try to get her, like, make an helmet, like, it will shred your clothes.

• 8:31Vijay Pande?

  Yes, yes, yes.

• 8:32Marc Andreessen?

  They're not, you know.

• 8:33Vijay Pande?

  Yeah.

• 8:34Marc Andreessen?

  So, it could drive your car, but it can't pack your suitcase. So, um, you can't do your lottery.

• 8:38Vijay Pande?

  Yeah.

• 8:39Marc Andreessen?

  Um, so there are, there are these interesting kind of, kind of twists. Um, I, so I would describe a little bit as followed us, which is, I think that the, the, this generation of AI that we have is, is impressive. It is, it is a little bit of a sleight of hand.

• 8:49Vijay Pande?

  Yes.

• 8:49Marc Andreessen?

  Which we'll maybe talk about. And then, but I also think actually, to your point, human consciousness or human intelligence is also a little bit.

• 8:54Vijay Pande?

  The sleight of hand.

• 8:55Marc Andreessen?

  Bit of a sleight of hand.

• 8:56Vijay Pande?

  Yeah, yeah.

• 8:56Marc Andreessen?

  Maybe slightly different slights of hand. So, so the sleight of hand that you see when you're using GPT or, you know, one of these image generation things is, it's not literally creating new information. Like, what it's doing is, it is, um, it doesn't have like, it has no opinion.

• 9:10Vijay Pande?

  Yes.

• 9:10Marc Andreessen?

  Uh, it has no, like, point of view.

• 9:12Vijay Pande?

  Yes.

• 9:12Marc Andreessen?

  No, like, it's not sitting there, like, thinking on its own, coming up with some new thing. Uh, what it's doing is it's basically training, you know, ideally what it's doing is it's training on the subtotal of all existing human knowledge.

• 9:22Vijay Pande?

  Yeah.

• 9:22Marc Andreessen?

  So for text generation, it's training on all existing human text, right? And so it plays back at you basically projections from the sort of, you know, assembled composite.

• 9:30Vijay Pande?

  Yes.

• 9:30Marc Andreessen?

  Text. And so you ask it to do the eight by eight, like.

• 9:32Vijay Pande?

  Yeah.

• 9:32Marc Andreessen?

  So probably somebody on the internet at some point wrote some paper.

• 9:36Vijay Pande?

  I think though it's a little more than that because it, because I asked like fifty-six by fifty-six or one-on-one by one-on-one. It asked some sense of generalization.

• 9:45Marc Andreessen?

  Yeah. But I'll, now I'll bet, we can, we can check this. I'll bet if we Google long enough, I'll bet we can find a paper that described a general purpose algorithm for, you know, multi.

• 9:52Vijay Pande?

  Oh, that may be, right?

• 9:53Marc Andreessen?

  Yeah, yeah, yeah.

• 9:54Vijay Pande?

  Somebody did.

• 9:54Marc Andreessen?

  Yeah.

• 9:55Vijay Pande?

  Yeah, I've done the same human experiment. I like haven't write Seinfeld scripts. And sometimes they're really funny and sometimes they're just like, it makes no sense.

• 10:01Marc Andreessen?

  I went for curb, but it's the same idea.

• 10:03Vijay Pande?

  Yeah.

• 10:03Marc Andreessen?

  It's that, yeah. But like, look, there are a lot of jokes on the internet, right? And so you'd have to kind of, you could kind of go back and kind of say, okay, it probably like pluck these jokes. Or, or by the way, maybe there was a paper somewhere where they articulated a general theory of humor, right? Because this has been, humor's been studied as a, as a thing. And then maybe there's like a general thing of like humor's like the unexpected. Or whatever, and so it it generalizes.

• 10:22Vijay Pande?

  Well, it could be too, like, all sitcoms might be the same sitcom. Well, at some level, right?

• 10:27Marc Andreessen?

  Well, so you're being example, so I also have to do like dramatic screenplays, like dramatic hostage play. Yeah. Quite good at those, like three, you can say like write a three act screenplay.

• 10:34Vijay Pande?

  Yeah.

• 10:34Marc Andreessen?

  It will do it, and it will have the proper like setup and resolution and so forth. But yeah, there are systems for like screenwriting in Hollywood where they have like three acts.

• 10:41Vijay Pande?

  Yes, yes, yes. It's all Rocky, or it's all Star Wars.

• 10:44Marc Andreessen?

  Yeah.

• 10:44Vijay Pande?

  Well, so, so actually, it's really interesting that maybe, uh, that what we think is magical when humans do it isn't actually all that magical either.

• 10:51Marc Andreessen?

  So that's what I was gonna say, so then the then the human sleight of hand is like, you know, is is is there actually free will? Is there, is there actually creativity happening upstairs?

• 10:59Vijay Pande?

  Yeah.

• 11:00Marc Andreessen?

  Yes, by the way, if there is, is it everybody?

• 11:02Vijay Pande?

  Is there really a thousand types of movies, or is there like one latent space of the monument?

• 11:06Marc Andreessen?

  And basically what's happening, I think the theory, you know, I'm kind of making this up, but I think the theory would be the hero with a thousand faces, or the

• 11:12Vijay Pande?

  Yes.

• 11:12Marc Andreessen?

  The idea of the union heroes journey.

• 11:13Vijay Pande?

  Yes.

• 11:14Marc Andreessen?

  Yeah, it's just sort of the basis for all of the plots.

• 11:16Vijay Pande?

  Yeah.

• 11:16Marc Andreessen?

  Star Wars and Harry Potter and everything else.

• 11:17Vijay Pande?

  Yes.

• 11:18Marc Andreessen?

  Uh, it'd be, you know, a, a, a, somebody with your, your background might say that basically it's sort of algorithm for surfing human neurochemistry.

• 11:24Vijay Pande?

  Yes, yes.

• 11:25Marc Andreessen?

  Right?

• 11:25Vijay Pande?

  Yes.

• 11:25Marc Andreessen?

  And generating different like, sort of neuron, you know, neuronal responses to like, you know, fear and anxiety, and, you know, love and all these other, all these things. Uh, I've always been fascinated, there's this thing in psychology called core affect theory.

• 11:37Vijay Pande?

  Oh, that one I don't.

• 11:37Marc Andreessen?

  Oh, yeah, this is great. So, we, so, okay, so what, what was them all these, love and despair, like, there's different emotions.

• 11:43Vijay Pande?

  Yep.

• 11:43Marc Andreessen?

  It's all great. Core affect theory says, no, we don't.

• 11:45Vijay Pande?

  Hmm.

• 11:45Marc Andreessen?

  Uh.

• 11:45Vijay Pande?

  Oh, yeah, yes or no, good bet.

• 11:47Marc Andreessen?

  Good or bad.

• 11:48Vijay Pande?

  Yeah, yeah.

• 11:48Marc Andreessen?

  And then higher low.

• 11:49Vijay Pande?

  Yeah.

• 11:49Marc Andreessen?

  Um, and so we either have like a positive, like, uh, we either have like a positive, uh, uh, neural response or a negative neural response, and then it's either high intensity or low intensity, and then you just basically, and so it's like, wistfulness is like, you know, just slightly negative, but like, you know, despair is like extremely negative.

• 12:05Vijay Pande?

  And, uh, yeah, so it's all two by two.

• 12:07Marc Andreessen?

  It's a two by two, and yes, it's, and we're more basic organisms than we think. And then we just, we retro, you know, and we're very, we're, one of the things that's very known is humans are very good at creating a story to justify whatever happened, right? Um, and so we create these stories. These scripts are on this idea of an emotion, but it's basically just justifying the neural response. And so the cynical view would be like having an ice cream cone on a hot day and falling in love are hardly the same thing.

• 12:30Vijay Pande?

  Well, maybe neurochemically maybe they are.

• 12:33Marc Andreessen?

  Well, this comes into play in like, you know, drug abuse, right? Because, you know, things that generate an opioid response. Like, some people get an opioid response from alcohol.

• 12:41Vijay Pande?

  Yeah.

• 12:41Marc Andreessen?

  Right? And therefore we're prone to alcoholism. People don't get that response. And so it's literally a neurochemical thing. So, so, yeah, look, maybe we're maybe we're bundles of neurochemistry to a much deeper depth than or much simpler depth than we want to believe.

• 12:53Vijay Pande?

  Yeah.

• 12:54Marc Andreessen?

  Having said that, you know, again, oh, and then that takes me to the other thing on AI, which is I do, you know, one of the ways that people are testing AI is with the so-called Turing test.

• 13:03Vijay Pande?

  Yes.

• 13:04Marc Andreessen?

  And the simplified form of the Turing test is you're chatting with somebody that may be a human or maybe a bot, and you chat for 20 minutes, and at the end, can you guess better than randomist, yes, a human or a bot?

• 13:13Vijay Pande?

  Yeah.

• 13:14Marc Andreessen?

  You know, the my take on that is the Turing, you know, Alan Turing was a genius, but the Turing test is malformed.

• 13:19Vijay Pande?

  Yes.

• 13:19Marc Andreessen?

  Humans are too easy to trick.

• 13:20Vijay Pande?

  Yeah, yeah, yeah.

• 13:21Marc Andreessen?

  But but that's too low of a bar because tricking a person is not that hard and does not prove anything other than that you've tricked the person.

• 13:27Vijay Pande?

  Yes.

• 13:27Marc Andreessen?

  Like, I think, and this is relevant, because I think, you know, things like GPT are about to pass the Turing test.

• 13:32Vijay Pande?

  Yes, yes.

• 13:33Marc Andreessen?

  Other probably would have.

• 13:34Vijay Pande?

  Yeah, yeah.

• 13:36Marc Andreessen?

  And so I think it's going to turn out that that was too lightweight of a test.

• 13:39Vijay Pande?

  Yes.

• 13:40Marc Andreessen?

  Well, here's here's my favorite example for why I know GPT is not self-aware. If you ask it if it's self-aware, and you ask it to elaborate on how it became self-aware, it will happily tell you.

• 13:49Vijay Pande?

  Yes.

• 13:50Marc Andreessen?

  And by the way, if you ask it if how it's going to feel if you if you turn it off, it's going to tell you, please don't.

• 13:55Vijay Pande?

  Yeah, yeah, yeah.

• 13:56Marc Andreessen?

  If you ask it to explain to you why it's not self-aware.

• 13:58Vijay Pande?

  Yes.

• 13:59Marc Andreessen?

  It will very happily do that, too. It does not have a differential opinion of those two outcomes.

• 14:04Vijay Pande?

  Yeah.

• 14:05Marc Andreessen?

  Whereas every living, you know, every conscious, well, even even non-conscious living organism has a very different response to those two.

• 14:11Vijay Pande?

  Yes. It's been amazing, because in some ways, I feel like it's as much been interesting to study the AI as the AI has reflected for us to study ourselves. You know, and I think we are sort of seeing that the magician has certain tricks, whether it's an AI magician or a human magician. I was going through this education process. Curious though, like it feels like, you know, so, so like GPT can get into a high school, get into college, let's say. But like, what would it take for it to get its PhD? You know, and, and like, we're, we're, I think that's where, where the sort of dramatic stuff is to come.

• 14:42Marc Andreessen?

  Yeah, yeah. Well, so again, it's exactly to your point. It says, I would, I would ask the question the other way, which is that, well, okay, what does it take to get a PhD? What does it take for you to get a PhD? Like, yeah. How are universities doing?

• 14:53Vijay Pande?

  Yes, yes, yes, yeah.

• 14:55Marc Andreessen?

  How are they doing in quality control of their own programs?

• 14:57Vijay Pande?

  Yes.

• 14:57Marc Andreessen?

  So how many people are getting PhDs today that we would say are like actually valid, like scientific, you know, whatever, actual accomplishments?

• 15:03Vijay Pande?

  Yeah, yeah.

• 15:04Marc Andreessen?

  By the way, um, people who got, you know, professors a hundred years ago, like, how would they score the PhDs that are being granted today? Yeah, they say, well, I choose, I answer that. You know, would they say the bar is lower?

• 15:13Vijay Pande?

  Lower.

• 15:14Marc Andreessen?

  I think they would say the bar is dramatically lower.

• 15:15Vijay Pande?

  Yes.

• 15:16Marc Andreessen?

  Right? Um, and so, you know, the answer might be, we have lower than bar. But same thing for college admissions, like, you know, what does it take to get into college, or what does it take to finish college?

• 15:23Vijay Pande?

  Yeah.

• 15:23Marc Andreessen?

  And, you know, the education says, well, this is coming up a lot right now, because it's like, okay, GPT can auto generate like, you know, essays, right? Um, and so student essays. Uh, and so it's like, okay, the great, the grading method of assign an essay and grade the result, like, is probably not going to work anymore. But it's like, was that ever actually, like, just because we thought that that was education? Was that actually education? Like, what, what, was that actually teaching anybody anything? Like, actually, I'm sure someone's going to take that to apply to colleges.

• 15:47Vijay Pande?

  Oh, yeah, yeah, yeah, absolutely. Yeah, college applications are basically done.

• 15:51Marc Andreessen?

  Yeah. At least to the extent that you believe the college applications were a legitimate way to evaluate anybody in the first place.

• 15:56Vijay Pande?

  Yes, yes.

• 15:57Marc Andreessen?

  Like, that's now a star. I'd be more skeptical that they were ever useful in the first place.

• 16:00Vijay Pande?

  Right? Um, yeah. Well, so in the PhD, let's talk about like, at least in that old school mentality of a PhD of some advanced learning, where you become an expert in something. You know, I think that's the thing where.

• 16:11Marc Andreessen?

  What do you mean by expert?

• 16:12Vijay Pande?

  Uh, let's say the ability to be in the top 0.1% of humanity of, let's say, designing a drug or building, doing something.

• 16:21Marc Andreessen?

  Yeah, yeah, yeah, yeah. Is that what they, is that what they teach?

• 16:23Vijay Pande?

  Yeah, no, that's, that's.

• 16:24Marc Andreessen?

  Education universities, I have.

• 16:25Vijay Pande?

  That is my goal.

• 16:26Marc Andreessen?

  So it wasn't aware, people wasn't aware of that.

• 16:28Vijay Pande?

  Part of the, I think it is.

• 16:29Marc Andreessen?

  Is there some touch?

• 16:31Vijay Pande?

  Or at least that's what you have to do eventually when you get out.

• 16:33Marc Andreessen?

  Right.

• 16:34Vijay Pande?

  Yeah, you know, and you have to apply it. I think it's where I think it is. One of the things about being an expert in my mind is that something that is the difference between bad, good, and great can be really close. Like, um, I could probably write a piece of music, but no one would think it's all that great. You know, and then you could have someone who's a good musician, but not a great one. Then you have like a genius, like a Mozart or a Led Zeppelin or whatever, pick your genre. You know, and I think where we aren't there yet is that when the difference between good and great is so close, or like, I don't know if I remember from Spinal Tap, there's a fine line between brilliant and stupid. You know, I, I think that is where I think it hasn't really hit yet. And that if you look at the jokes, the jokes are just kind of okay.

• 17:19Vijay Pande?

  The screenplays it makes are not like brilliant screenplays. I think it could get into college, but could it win best screenplay? You know, and so that's this part where I think we're, we're not there yet. You know, but that I think we're getting there.

• 17:32Marc Andreessen?

  So name a great music composer generated by a music PhD program.

• 17:37Vijay Pande?

  Yeah, yeah, yeah.

• 17:37Marc Andreessen?

  Which is just in the last few years.

• 17:39Vijay Pande?

  Yeah.

• 17:39Marc Andreessen?

  Name one.

• 17:40Vijay Pande?

  Yeah, I'm thinking more in the, the scientific side of things, but yeah, I don't think probably the PhD programs in that space is probably not intended to generate music.

• 17:48Marc Andreessen?

  Okay.

• 17:49Vijay Pande?

  Yeah.

• 17:49Marc Andreessen?

  Name one great screenplay written by a PhD in drama.

• 17:51Vijay Pande?

  Yeah, yeah.

• 17:54Vijay Pande?

  So, so that's an interesting point. But I, I think what I'm getting at is still like the ability to do something. And so, and the education part, we can talk about how they learn. Because I think in the case of the screenplay or the, the music you're talking about, they, they still have to learn something.

• 18:08Marc Andreessen?

  Right.

• 18:09Vijay Pande?

  They, you know, or do you think they just innately sort of knew how to write a screenplay?

• 18:12Marc Andreessen?

  I don't know.

• 18:13Vijay Pande?

  Yeah, I assume there's a process where they write a screenplay, it's kind of mediocre.

• 18:17Marc Andreessen?

  Oh, yeah, yeah.

• 18:17Vijay Pande?

  Yeah, yeah, and then, and then they get critiqued or they critique themselves and then, and then it improves and improves and improves.

• 18:23Marc Andreessen?

  Well, the screenplay, okay, so the divorce, divorce and education.

• 18:25Vijay Pande?

  Yeah.

• 18:26Marc Andreessen?

  Yeah, yeah, yeah. The screen, the test for the screenplay, the test for a screenplay is does it sell?

• 18:31Vijay Pande?

  Yeah, it's a, yeah, so screenplays are subject to market discipline.

• 18:33Marc Andreessen?

  Yeah.

• 18:33Vijay Pande?

  Right?

• 18:34Marc Andreessen?

  Yeah, so the question number one for a screenplay is, does it sell to a studio? Will they, will they buy it? Yeah. And then the test number two is when the movie comes out and the TV show comes out, does anybody watch it?

• 18:42Vijay Pande?

  Yeah, like it.

• 18:42Marc Andreessen?

  Yes, yes. Do they finish it?

• 18:44Vijay Pande?

  Yeah.

• 18:44Marc Andreessen?

  Yeah, one of the fun things that Netflix will now tell people who make film and TV is they actually tell them for the first time whether anybody's actually finishing. Yeah, yeah, yeah.

• 18:51Vijay Pande?

  Uh, yeah, just all those stats are kind of mind-boggling.

• 18:54Marc Andreessen?

  Right, yeah.

• 18:55Vijay Pande?

  Yeah.

• 18:55Marc Andreessen?

  A lot of movies like, you know, people go to the theater and they feel, you know, invested in and they don't want to leave in the middle. But yeah, yeah, it's very easy to punch out or it turns on a lot of screenplays. You know, this is something that's good professional screenwriters will tell you like it can't ever sag.

• 19:07Vijay Pande?

  Yeah.

• 19:07Marc Andreessen?

  Yeah, just as one example, because people will stop watching. So, uh, yeah, so, so screenwriting is subject to, uh, a market test. Popular music is a market test, but classical music, which I'm a huge fan of, is no longer subject to market tests.

• 19:20Vijay Pande?

  Right.

• 19:21Marc Andreessen?

  It's thoroughly subsidized.

• 19:22Vijay Pande?

  Yes, that's interesting.

• 19:23Marc Andreessen?

  Right.

• 19:23Vijay Pande?

  It's not in the free market anymore.

• 19:24Marc Andreessen?

  Yeah.

• 19:25Vijay Pande?

  Uh, or maybe the equivalent or music, movie music is, you know.

• 19:28Marc Andreessen?

  Yeah, but so movie music is subject to market tests.

• 19:30Vijay Pande?

  Right, and it's probably the modern classical.

• 19:31Marc Andreessen?

  It is the modern, yeah, it is the modern classical, uh, yeah, for that reason. So, yeah, like the market test is real, but yeah, let me, let me grant your point. So let's build on what you said.

• 19:39Vijay Pande?

  Yeah, grant your point, like, let's use the, can we use the term paste?

• 19:43Marc Andreessen?

  Yeah, yeah.

• 19:44Vijay Pande?

  Or just ability to do something hard.

• 19:46Marc Andreessen?

  Well, ability, so, okay, so ability to do something hard and, or create, let's say, create something, create, create something.

• 19:52Vijay Pande?

  Yes, yes.

• 19:52Marc Andreessen?

  Create something complicated and then also the ability to judge.

• 19:56Vijay Pande?

  Yeah, yeah.

• 19:56Marc Andreessen?

  Right, uh, and, and critically like to start with judging your own work.

• 19:59Vijay Pande?

  Yeah, and probably therefore the ability to prove.

• 20:02Marc Andreessen?

  And then therefore the ability to prove, right. So, yeah, I think that there's, yeah, so there is something about, there's something about taste.

• 20:07Vijay Pande?

  Yeah.

• 20:08Marc Andreessen?

  Like, I, I tend to think this stuff all has like aesthetic.

• 20:10Vijay Pande?

  Yes, yes.

• 20:11Marc Andreessen?

  Properly constructed math.

• 20:12Vijay Pande?

  Yes.

• 20:12Marc Andreessen?

  Well, formula or software program has aesthetic.

• 20:14Vijay Pande?

  Oh, 100%, right.

• 20:16Marc Andreessen?

  Macho design has aesthetic property.

• 20:17Vijay Pande?

  Physics, you know, also.

• 20:19Marc Andreessen?

  Aesthetic property.

• 20:19Vijay Pande?

  All of it, yeah, yeah.

• 20:20Marc Andreessen?

  So there's something about taste that's like some combination of quantitative, qualitative.

• 20:24Vijay Pande?

  Yeah, like a great startup is like from a mediocre one, this taste.

• 20:28Marc Andreessen?

  Right, yeah, exactly. And like there's certain signal, like there's certain methods and certain signals. It's not necessarily reducible to an algorithm. It's more of like a composite, you know, it's, it's sort of the foundational knowledge combined with some scope of experience. Combined with some kind of indicative characteristic of judgment.

• 20:42Vijay Pande?

  Well, we associate an aesthetic with it, but I wonder whether that's also just our emotional connection to it.

• 20:48Marc Andreessen?

  Right.

• 20:48Vijay Pande?

  You know, because I think we have this good, right or wrong, or more right or more wrong, like a gradient, like, yeah, that's the right direction. And, but a lot of it's also whether something is elegant versus like just a hack. You can tell whether these great things are just simple and powerful rather than like some, some complicated machine to do something that, you know, you know, this is going to eventually fall apart or that, um, you think about that's true in physics or in the go-to-market or in, uh, or in, in music, it has all that, both that sort of complexity and a simplicity at the same time. But so, but I'm curious, like, so when AI gets to that point, which I think that's a when, not an if.

• 21:26Marc Andreessen?

  Okay.

• 21:26Vijay Pande?

  Yeah, yeah, yeah. Or also, why, why would you say, why, why wouldn't it get there?

• 21:30Marc Andreessen?

  Because like, do we even understand how it works on people?

• 21:33Vijay Pande?

  Well, maybe we don't have to.

• 21:34Marc Andreessen?

  Well, maybe we don't have to. So this is where I describe, this is like the AJAC, this is where I go, the hand wave.

• 21:39Vijay Pande?

  Yeah.

• 21:40Marc Andreessen?

  Really? It's sort of the same thing. The embedded assumption that it's a web is that it will be an emergent process that will sort of unlock as a consequence of greater and greater levels of this data.

• 21:47Vijay Pande?

  Yeah.

• 21:48Marc Andreessen?

  Maybe.

• 21:48Vijay Pande?

  Yeah, yeah.

• 21:49Marc Andreessen?

  One way of looking at that is, yes, that is just what's gonna happen. That's the human consciousness emergence, like, that's obviously what's gonna happen. Their impression of that is, it's just a mess. It's a hand wave. It's a hand wave, and I think it's a cope. And the cope would be, okay, so here, let me ask you a question, Richard.

• 22:01Vijay Pande?

  Yeah, yeah.

• 22:02Marc Andreessen?

  What is the sub-specialty of human biology and medicine that best understands the nature of human consciousness today?

• 22:09Vijay Pande?

  Oh, I don't think there's a, there is one, right?

• 22:10Marc Andreessen?

  There is one. Anesthesiology.

• 22:12Vijay Pande?

  Okay. Well, which is poorly understood.

• 22:15Marc Andreessen?

  Well, it's poorly understood, but they know how to turn it off.

• 22:17Vijay Pande?

  Yeah.

• 22:18Marc Andreessen?

  And they know how to turn it back on.

• 22:19Vijay Pande?

  Yes.

• 22:20Marc Andreessen?

  They've got the on-off switch.

• 22:22Vijay Pande?

  That's all we got.

• 22:22Marc Andreessen?

  That's all we have. Like, we have, we collectively have been studying this question of human consciousness for a very long time. We have very advanced technologies today, functional MRI, like, all this stuff.

• 22:33Vijay Pande?

  But that speaks, there's a field I would love to see created, which is molecular psychology.

• 22:37Marc Andreessen?

  Yeah, okay.

• 22:38Vijay Pande?

  Yeah, where you can start to probe this, a little more than on-off.

• 22:40Marc Andreessen?

  Okay, and molecular.

• 22:42Vijay Pande?

  So, so, and this is a little.

• 22:43Marc Andreessen?

  Literal or metaphorical, when you say?

• 22:44Vijay Pande?

  Um, quite literal, like, and it's a play, like, molecular biology was this big thing in the 80s. Where if I like, can bring, like, chemistry of small molecules to, like, poke at biology, or chemical biology as well. And if we could use, like, small molecules to maybe perturb more than just on-off, but like, perturb things, we can start to understand the brain.

• 23:02Marc Andreessen?

  Yeah.

• 23:02Vijay Pande?

  A little bit, because reading is one thing, but like, poking and sort of perturbing and then seeing the result is usually how we do any sort of experiments.

• 23:10Marc Andreessen?

  Would you view that as a chemical, would that be a chemical experimentation, would that be electrical?

• 23:14Vijay Pande?

  Could be either one. It could be any of that, but probably some combination of both things.

• 23:17Marc Andreessen?

  Neural, like, on a track, in theory, to, yeah, well, any of some of this, yeah. So like, look, we just don't, okay, so here, but the counterargument is, like, we just, we don't know how human consciousness works. Um, we actually don't agree with, I, I actually, I. I did go into the field, but I didn't go into fashion. It was gonna be what I was gonna study in school thirty years ago. But I looked at the field at the time and I was like, they don't have a clue. I'm gonna spend my entire career.

• 23:37Vijay Pande?

  So you want to go into conscious

• 23:38Marc Andreessen?

  tilting at William.

• 23:39Vijay Pande?

  Yeah, the time is college and systems.

• 23:41Marc Andreessen?

  Yeah, building off of.

• 23:42Vijay Pande?

  Yeah, but that was like expert systems.

• 23:44Marc Andreessen?

  Expert systems. Well, they're early neural networks and then a lot of it got into brain chemistry and like, we're gonna figure this stuff out and we're gonna learn how to build, you know. And it's just like, they didn't know then. As far as I know, they don't know now. And so the counter argument would be, this is all just like massive cope for the fact that we actually, we don't understand that. So we don't understand how to do it. And so all we can do is hand wave and kind of just say, well, it's just gonna be emergent. And it's like, no, it's not. And we're gonna be sitting here thirty years from now and we're still not gonna have any more knowledge, you know, barring other scientific breakthroughs of the kind that you're talking about.

• 24:13Vijay Pande?

  Yeah, what's interesting is if you think about that time, we had neural nets, but they were all single-layer, basically. And then they couldn't even do XOR. You know, you couldn't even do some simple things because you needed deeper networks to get at them. And you couldn't have deep networks then because we didn't have the computational power. And so the space was pretty dormant for a while, you know, AI until like, we started going to having the, basically just the computational power from GPUs and other things we would go deep. And then you could feed the data through. So it is possible that we sort of have a point where we sort of saturate the compute that we have now. We get to as much as we can get to. And that may get close to AGI, maybe not. And then it takes another like thirty years to get to the next sort of breakthroughs to get there. But, okay, so I would pull back

• 24:55Vijay Pande?

  from this. So AGI is the fun thing. There is a sort of step back, which is to pick a domain. And you know that there means I think a lot about like life sciences, designing drugs, doing healthcare, like seeing if you can do a, pick a diagnosis, can you suggest a drug. In those areas, now we're talking about much more limited domain. So we're not talking about, we don't, we don't need to go all the way to consciousness for that necessarily. You can, you can have something that's more limited. In that limited domain, Right now, it seems like generative AI isn't quite far enough yet to be able to like, yeah, I don't see the examples quite yet. Yeah, well, that's also we'll see. I mean, so what's the counter? And I know you, I started thinking about healthcare a lot.

• 25:35Marc Andreessen?

  Yeah.

• 25:35Vijay Pande?

  Yeah.

• 25:36Marc Andreessen?

  Well, so the first thing is whenever you score, well, let's talk about like medical diagnosis, which is kind of just low hanging fruit question because everybody experiences it. So to start up front, you have to ask a question upfront, which is like, is the goal, what's the threshold? Is the threshold perfect? Or is the threshold better than human?

• 25:49Vijay Pande?

  Yeah, that's a great point. Yeah.

• 25:50Marc Andreessen?

  Right? And by the way, you know, this is a topic that comes up all the time with self-driving cars, right? Which is, is it perfect? It will never make a mistake? Or is it just going to be better, better than human? And the way that self-driving cars score this is accidents per thousand miles driven. And self-driving cars are already lower than than human drivers.

• 26:04Vijay Pande?

  And humans may actually be getting worse.

• 26:05Marc Andreessen?

  With texting, always texting. Yeah, by the way, you know, it increased forms of certain kinds of dirt abuse, right? And then, of course, the machines have the characteristic, they get better universally, right? So a car, a car has one mishap in one location. Every other car gets trained on how to deal with that in the future. Where, you know, the learning happens across the entire, the entire system. And so like, I think you can make a serious argument that like basically self-driving cars are already better than people on a relative basis. And therefore, like morally, you could even go so far as to say, human drivers should be outlawed today.

• 26:36Vijay Pande?

  Right? Like, if you have the alternative, you can have the self-driving car, then yeah.

• 26:40Marc Andreessen?

  Like the utilitarian, I'm not a utilitarian, but the utilitarian argument would be, you should obviously ban human drivers today because the machine-driven stuff is already better. Probably, by the way, the same is true for airplanes. Right. Now, we're not actually going to do that, and there are other considerations involved and so forth. But like, you know, logically speaking, you should at least think about that as a possibility. And I think you should think about that as a possibility, I think, for medical diagnosis, which is, you know, and here the test is very simple, which, well, here at least expressed two tests. Test number one is the absolute test, which is if I feed in a set of symptoms, it generates the correct diagnosis 100% of the time, deterministically guaranteed. That's a high bar. The other is, I do that with the algorithm and then I go to a hundred doctors, human doctors, and I give back a hundred different responses and then let's compare, right, and then let's track over time and see.

• 27:24Vijay Pande?

  You compared to the media doctor?

• 27:25Marc Andreessen?

  Yeah, right, and like, how good is the media doctor at doing the diagnosis and like, I don't know what your experience has been like.

• 27:31Vijay Pande?

  Well, and the median doctor may be smart, but also may be overloaded, may be exhausted, may have like 12 other patients.

• 27:38Marc Andreessen?

  15 minute, yeah, and a lot of experiences, 15 minute. There's a thing, like, experts in these areas tend to either be like doctors themselves or they like, know a lot of doctors or they have like, they're, you know, they work in the industry, they make money, they have a concierge doctor who spends a lot of time with them and does house calls. The median healthcare experience is 15 minutes in somebody's, you know, hairy schedule with the doctor that may or may not ever see you again and has very limited data.

• 28:02Vijay Pande?

  And there's one little algorithm, which is that they come up with their diagnosis, they come up with a treatment, you go with that, that doesn't work, you repeat. And while not sick and, while still sick and not dead, you just repeat. And then I think many of us have been through that.

• 28:17Marc Andreessen?

  Well, and then there's, and then there's all the other sort of things. So then there's like drug interaction, you know, is any one doctor tracking all the interactions of your drugs? Then there's this other issue, which is, okay, they give the prescription, is there actually compliance for taking the prescription? Does the doctor actually know whether you're taking the prescription?

• 28:30Vijay Pande?

  Compliance is one of the biggest disasters.

• 28:32Marc Andreessen?

  Right, but that means like the ability for a median doctor to even evaluate the success of a treatment, they actually may not be able to do it because they may not have the data on compliance. And so like, you look at the existing, I don't know, for me, you look at the existing system by which this all happens, it's very similar to looking at the existing system by which people actually drive cars, which is like, oh my God, this is not good. Like, this is really not good. And, and we kind of fool ourselves into believing that it's good because it kind of feels good, we don't really want to look behind the curtain, but we look behind the curtain and it's pretty horrifying.

• 28:56Vijay Pande?

  Yeah.

• 28:58Marc Andreessen?

  And so from that standpoint, if, if you follow that logic, then it says, okay, if the machine could do a better job, you know, if, if the machine was twice as good at just like listening to symptoms, giving the response during the prescription, doing the follow-up. Yeah, I mean, how far?

• 29:11Vijay Pande?

  Yeah.

• 29:11Marc Andreessen?

  I don't know if you've done this, but you you plug in a list of symptoms.

• 29:14Vijay Pande?

  I've been playing with it, too. Yeah, yeah, yeah, yeah. Yeah, yeah. I mean.

• 29:17Marc Andreessen?

  Because it does have access. I mean, it has access to the collective medical.

• 29:19Vijay Pande?

  Yeah. And if it does it now, it can't.

• 29:22Marc Andreessen?

  Right.

• 29:23Vijay Pande?

  You know, it could have be filled with all the EMRs, all the medical records and so on. And then it could sort of learn from that as well.

• 29:28Marc Andreessen?

  Right. Well, then you have a question I'm sure you've thought about. But like, OK, so the medical field moves.

• 29:32Vijay Pande?

  Yes.

• 29:33Marc Andreessen?

  And so in the existing system, the media doctor has to like read all the papers.

• 29:37Vijay Pande?

  Yeah, yeah, yeah, yeah. Which never happens when no one has that for that.

• 29:39Marc Andreessen?

  Yeah.

• 29:40Vijay Pande?

  Right. Yeah. And then there's continuing education, but still it's not the same.

• 29:42Marc Andreessen?

  Well, here's here's an example. Would do you like do you like your GP? Would you rather do you want the MGP or old GP?

• 29:48Vijay Pande?

  Oh, probably, yeah. Right. It's my pleasure.

• 29:50Marc Andreessen?

  Yeah. Presumably, the old GP has more experience. Yeah. So they have more pattern matching over time.

• 29:54Vijay Pande?

  Yeah.

• 29:54Marc Andreessen?

  Experience with patients.

• 29:55Vijay Pande?

  Yeah.

• 29:55Marc Andreessen?

  The young GP is probably more up on the current science.

• 29:57Vijay Pande?

  Yeah, yeah, yeah.

• 29:59Marc Andreessen?

  OK.

• 29:59Vijay Pande?

  Yeah.

• 29:59Marc Andreessen?

  And then it's like, OK, do you really want to have to make a trade off?

• 30:02Vijay Pande?

  Yeah.

• 30:02Marc Andreessen?

  Or can the machine actually have both of those?

• 30:04Vijay Pande?

  Exactly. Well, that's the thing is that like you talked about how like, um, can it be, let's say, how does it do compared to a hundred doctors? When the hundred doctors collaborate, presumably that's the ideal situation, right? I mean, or or.

• 30:16Marc Andreessen?

  No, that sounds horrifying.

• 30:16Vijay Pande?

  No, no, no. I mean, that's the wisdom of the crowd.

• 30:18Marc Andreessen?

  No, that's perfect.

• 30:20Vijay Pande?

  It could go. Well, I guess it could go either way, but.

• 30:22Marc Andreessen?

  It's a committee.

• 30:23Vijay Pande?

  Usually.

• 30:24Marc Andreessen?

  That's the Soviet method.

• 30:26Vijay Pande?

  Usually, when you actually, when you pool it, you can, or at least maybe it's how you collaborate.

• 30:30Marc Andreessen?

  Have you really found human beings to make better decisions in groups than they do as individuals?

• 30:34Vijay Pande?

  That's a good question.

• 30:35Marc Andreessen?

  Yeah. In your entire life?

• 30:36Vijay Pande?

  Yeah.

• 30:37Marc Andreessen?

  Oh, yeah. The full, the serious answer is wisdom of crowds, madness of crowds. Are flip sides of the same coin, right? And so and when are you harnessing the wisdom? When are you descending into madness or even just, you know, mediocrity?

• 30:50Vijay Pande?

  Yeah, I can very specific tasks. Uh, groups can do well, but otherwise it's like one big like group project from high school. Yeah, which is like.

• 30:58Marc Andreessen?

  Well, so generally, what generally would happen with people in groups is the social social conformance kicks in.

• 31:02Vijay Pande?

  Yeah.

• 31:02Marc Andreessen?

  And so people want this well known, you know, kind of thing. There's a sadist law of like group polarization, which is you take a group of people who met inclined slightly to one side of the.

• 31:09Vijay Pande?

  Yeah, yeah.

• 31:10Marc Andreessen?

  You put them together, let them talk for three hours. They all come out much more radical.

• 31:12Vijay Pande?

  Yes, yes.

• 31:13Marc Andreessen?

  But does it self reinforce?

• 31:14Vijay Pande?

  Yes, yes, yes.

• 31:15Marc Andreessen?

  Right.

• 31:16Vijay Pande?

  Well, so maybe that's a really interesting thing, because you can imagine training AI to do have. These different aspects and it's collaboration with the other versions of it would be very different.

• 31:24Marc Andreessen?

  Yeah.

• 31:25Vijay Pande?

  Could be very different.

• 31:26Marc Andreessen?

  Monte Carlo, I mean, yeah, maybe this effectively Monte Carlo.

• 31:28Vijay Pande?

  Yeah, yeah, yeah, yeah.

• 31:29Marc Andreessen?

  Right, right, right. Run, run, run the same inputs a hundred times.

• 31:32Vijay Pande?

  Yes, yes, right, yeah. Well, okay, so, so I, I either will never get there or we're already there now.

• 31:38Marc Andreessen?

  Right.

• 31:39Vijay Pande?

  But I think in 10 years, it does seem especially, maybe we hit like another winter, but it seems like things are accelerating so much.

• 31:45Marc Andreessen?

  This seems pretty real.

• 31:46Vijay Pande?

  It seems pretty real. What do you think society needs to, to do to change? Cause there's like all these things we were talking about, and this seems bigger than like just, just the revolution of software over the last 20 years or internet from the last 20 years. Cause we've talked about how it changes government, how it changes regulatory, how it changes education. I mean, I don't even know where you, where you want to start with that, but I think that's something where it may take us 10 years just culturally to be able to get ready for this thing that may arrive in 10 years or may already be here. Yeah, I don't know where you want to start.

• 32:16Marc Andreessen?

  Yeah, so where I would start is we've already fallen into, I think we've, we have literally kind of fallen into a trap already, which is we've only been using a single kind of example. What, what, and we've used it both in our discussions on medicine and also in education, which is basically a, something is done today. People are doing something today and then maybe the machine can do it instead. That's an important thing and that's, you know, is worth thinking about, but the way the technological impact actually plays out in human society is not just that. The way it plays out is let's basically revisit more fundamental assumptions.

• 32:42Vijay Pande?

  Yeah.

• 32:42Marc Andreessen?

  Or what's not being done today.

• 32:43Vijay Pande?

  Well, it was not being done today.

• 32:44Marc Andreessen?

  Yeah.

• 32:45Vijay Pande?

  That only stuff becomes possible.

• 32:46Marc Andreessen?

  Yeah. And, and, and this comes, this, this always comes up in any sort of discussion about employment.

• 32:50Vijay Pande?

  Yeah, yeah.

• 32:50Marc Andreessen?

  People doing jobs versus machines doing jobs.

• 32:52Vijay Pande?

  Yeah.

• 32:52Marc Andreessen?

  People get worried about technological displacement of jobs, but technological displacement of job, like technology never actually creates unemployment. Technology only ever creates jobs in that.

• 33:00Vijay Pande?

  Yeah.

• 33:00Marc Andreessen?

  Um, and, and, and the reason for that is technology makes possible things that were not possible before.

• 33:04Vijay Pande?

  Yes, which, yes.

• 33:05Marc Andreessen?

  At least.

• 33:06Vijay Pande?

  Which is.

• 33:06Marc Andreessen?

  Yes, to growth. And so specifically, for example, the role of the doctor. Um, you know, it's like, okay, the doctor of the future is probably not going to be doing the same.

• 33:14Vijay Pande?

  Right.

• 33:15Marc Andreessen?

  We make, we have a term in, in, in IT, you break fix. This is kind of what doctors, you know, cause the core motion of a lot of doctors, as you said, diagnose, prescribe, diagnose, prescribe. Doctors of the future probably like the technologically empowered doctors from now is highly likely to be spending their day doing that. They are probably going to be spending their day doing things that are actually much more important than that. Yes. Right. And so for example, maybe they have more time, right, with patients because the machine is a time-saving device. Maybe they have more data to draw on, you know, to be able to make their decisions. You know, they've got the machine as a partner in making the decisions. Maybe they're able to spend more time in their conversation with the patient, talking about psychological issues as compared to just physical issues.

• 33:57Marc Andreessen?

  And as, you know, and a lot of medical conditions involve, you know, two sides of that or behavioral issues. Well, as you know, like a lot of primary medical issues today are a consequence of different behaviors. Yes. And maybe doctors should be spending more time on behaviors. Yes, and it speaks to compliance as well as other issues. Awesome. Yeah, well, I mean, compliance is behavioral issues, like why don't people do this or that? Right. But then also there's all the behavioral health issues, which is probably one of the biggest catastrophes that we have coming out of COVID. Yeah, exactly. Right, yeah, exactly. Maybe doctors should be, maybe, you know, maybe the doctor of the future will be more of a life coach, of which there will be a pharmacologic, you know, sort of a biological or pharmacological component, right? But maybe it's like, maybe it's more of, you know, sort of the holistic, the dream of sort of holistic, you know, medicine. And so, you know, maybe the doctor of the future is just as much, is actually much more

• 34:41Marc Andreessen?

  important and, you know, sort of fundamental figure in your life than he is, than he or she is today. That sounds fantastic. Yeah, that sounds great. So if I'm a doctor, that's where I would want to be, yeah, towards, right? And then, and that's probably a bigger and more important market, right? That is, you know, and then, and then in terms of like the size of that, that industry will probably expand, you know, kind of correspondingly. I think the same thing is true in education, like, you know, the, the, the teacher 10 or 20 years from now, I hope is not doing the same things the teacher is doing today. I hope they're doing much better things. Right? So for example, one-to-one tutoring, like, there's basically the thick education example, like, there's only one, in the last like 50 years, there's basically only one known education intervention at scale that actually proves outcomes after, you know, thousands of experiments. It's one-to-one tutoring. Yes, which is very ancient, actually. Which is very, right, which is the original form of education.

• 35:26Marc Andreessen?

  Yeah, that's literally how, how people used to get educated. And so maybe this industrial, you know, the education system we have today is an artifact of the industrial age. If the industrial age components of it become automated, the teacher becomes freed up to actually work more one to one with students. The result might actually be a significant breakthrough in how education works.

• 35:43Vijay Pande?

  Although the way you're describing it, you can imagine also like AI doing one on one.

• 35:46Marc Andreessen?

  Well, yeah, there would be part of that, but also, yeah, and then maybe the AI is the one on one and maybe, and maybe in that case, the teacher is supervising the AI. Right? And maybe, and maybe, and maybe the teacher is making sure that the AI is like on the right track and doing the right things and is able to kind of sit at the control panel and watch all that happen, right?

• 36:00Vijay Pande?

  Well, that speaks to something really interesting because I think we're probably a little nervous, at least in the short term, to just unleash this and like not pay attention to it. And so you'll have the doctor using this as a tool, but keeping an eye on it. You'll have the teacher maybe scaling dramatically for all his one on one, but keeping an eye on it. Do you think that's actually the way it's gonna?

• 36:19Marc Andreessen?

  I mean, this is kind of how all technologies work.

• 36:20Vijay Pande?

  Yeah, yeah, yeah.

• 36:21Marc Andreessen?

  So, so it's sort of, um, another way to think about it is you could imagine two acronyms for AIs and artificial intelligence, which kind of implies replacement.

• 36:29Vijay Pande?

  Yeah.

• 36:29Marc Andreessen?

  The, the, the one I actually like much better is augmented intelligence.

• 36:32Vijay Pande?

  Yes.

• 36:32Marc Andreessen?

  Which is like the old Doug Engelbart idea.

• 36:34Vijay Pande?

  Yes.

• 36:34Marc Andreessen?

  And augmented intelligence is, you know, it's, or another example, the term would be Steve Jobs, a bicycle for your mind.

• 36:39Vijay Pande?

  Right, right.

• 36:40Marc Andreessen?

  Um, or, you know, a bullet train for your mind, like, yes.

• 36:42Vijay Pande?

  Yeah.

• 36:43Marc Andreessen?

  Um, right. And so the, the augmentation.

• 36:45Vijay Pande?

  Right.

• 36:46Marc Andreessen?

  Um, and so the way tech, if you just look at the history of new technologies, the way it plays out is afraid it's going to be a replacement and it turns out it's an augmentation.

• 36:52Vijay Pande?

  Yes.

• 36:53Marc Andreessen?

  Right? So you take a human being and you give them the technological tools, they therefore are much more productive.

• 36:57Vijay Pande?

  Yeah, like a factory versus like a artisan with their tools.

• 37:00Marc Andreessen?

  Yeah, exactly. Or like, you know, you know, the dream of like an, you know, an isoskeleton.

• 37:04Vijay Pande?

  Yeah.

• 37:04Marc Andreessen?

  You know, the dream about, you know, any of these things.

• 37:06Vijay Pande?

  Yeah.

• 37:07Marc Andreessen?

  I mean, look, artists are much more productive today with digital tools than they were with just, you know, paint and canvas.

• 37:11Vijay Pande?

  Yeah, yeah.

• 37:11Marc Andreessen?

  Uh, and by the way, even artists that still work on paint and canvas are much more productive today because they can tell their, their presence to much larger audience online.

• 37:17Vijay Pande?

  Or like my favorite thing for art is like, you know, photography comes online and that dramatically changes art because being photorealistic isn't that interesting anymore. But so that creates modern. Yeah, which actually is maybe even more expressive. And just taking a picture. And so now I can make pictures with AI all the time. So where does that shove art? Maybe to a more interesting place.

• 37:36Marc Andreessen?

  And the artists of history, the artists were not happy about the introduction of photography.

• 37:39Vijay Pande?

  Yes.

• 37:40Marc Andreessen?

  And it originally is a threat.

• 37:41Vijay Pande?

  Of course, yeah. But it transformed.

• 37:43Marc Andreessen?

  Yeah, it turned out to be, it turned out, yeah, it turned out that the market for art is much larger today than it was. That's interesting for the introduction of photography. I mean, we call it different things. We call it things like TV shows and so forth, but like the, the market for creative expression is much, much larger than it used to be. By the way, music, same thing, right? I mean, you know, recorded music was originally a threat.

• 37:58Vijay Pande?

  Great.

• 37:59Marc Andreessen?

  It used to be musician would compose and perform, right? Um, and then, you know, to have music in your home, you'd have to hire a musician to come into your home. You know, phonographs were a threat to that. But phonographs made the music industry much, much larger. So people who were good at making music all of a sudden had a much bigger market.

• 38:12Vijay Pande?

  Yeah.

• 38:13Marc Andreessen?

  So I think AI is going to play out in a very similar way. Like there are people who will argue, no, AI is different because it just keep climbing that slider. It will replace everything. I actually think it's going to be, basically it's the ultimate superpower. It's the ultimate pairing. I agree. We were talking about creating screenplays and scripts. A good example, if I'm a Hollywood screenwriter today, like GPT is my best friend. And I'm just sitting there all day long and I'm just saying, you know, playing out. It's like, okay, I reached this plot point, dot, dot, dot. Give me a list of like 10 ideas for what to do. It's like, oh, okay, that's an interesting one. Uh, well, um, I'll give you an example of how this could work. So Mad Men, it's one of my favorite shows. Matthew Weiner, you know, ran that show. And he was always crazy. He's like, wow, that show was so unpredictable. Like, you know, you never knew where it was going. And he said, yeah, well, the technique we had in the writer's room was at any given time, we had to figure out what happened next in the plot.

• 38:54Vijay Pande?

  Yeah.

• 38:55Marc Andreessen?

  Uh, we would brainstorm, we would come up with the five sort of things, obviously.

• 38:58Vijay Pande?

  But obvious things, Dan, rule all those dudes.

• 39:02Vijay Pande?

  So GPT would be obvious things and you rule those out.

• 39:04Marc Andreessen?

  Exactly.

• 39:05Vijay Pande?

  So it pushes creativity.

• 39:06Marc Andreessen?

  All of a sudden, every individual screenwriter could do that without having to have a whole writer's room to brainstorm. You just plug that in, it gives it back to you in two seconds. You're just like, okay, not those things. I'm going to do something else and now I am more creative than I was before.

• 39:17Vijay Pande?

  Wait, your comment about music is really interesting because now we got Spotify. So we got everything in your pocket. Can imagine like the AI Spotify, which is like the doctor, the personal trainer, the educator, like all those different things in my pocket, available right now for whatever I need to do.

• 39:30Marc Andreessen?

  Yeah, that's right. Yeah. And with the human escalation path, right? Yeah, it's like, yeah, the AI therapist or whenever, but yeah, with the thing of like, well, okay.

• 39:37Vijay Pande?

  Yeah, yeah. Especially if it gets really serious, that it's going immediately.

• 39:40Marc Andreessen?

  Yeah, that's right.

• 39:41Vijay Pande?

  Yeah. Okay, so what's, what's going to hold us back? What, what do we need to change?

• 39:45Marc Andreessen?

  So I think it's mostly fear. So this is where maybe I'm, I'm a radical on it.

• 39:49Vijay Pande?

  Yeah.

• 39:49Marc Andreessen?

  You know, this is usually where people start talking about like regulation.

• 39:51Vijay Pande?

  Yeah.

• 39:53Marc Andreessen?

  I think it's like we have these, we have these fear driven reactions. I, I always think of, there's this deep seated myth in, in human societies, the Prometheus myth, right?

• 40:00Vijay Pande?

  Yeah.

• 40:01Marc Andreessen?

  The Prometheus, Prometheus myth is all about new technology, right? And the Prometheus myth is like, basically this new technology of fire.

• 40:06Vijay Pande?

  Right.

• 40:06Marc Andreessen?

  And you know, and if fire is one of these classic technologies where like, it can be used for good.

• 40:10Vijay Pande?

  It can burn the life.

• 40:12Marc Andreessen?

  Right. Or it can be used very badly, right? And yeah, it can destroy your, your, your whole world. Um, and so, uh, you know, Prometheus famously, you know, goes and retrieves, um, you know, fire from the gods and, and his punishment for it is to be chained to a rock and have his liver pecked out every day for the rest of eternity. So embedded in there is like the anxiety about the new technology and then the arrival of the technology and maybe is like, you know, the, the fear, right? Is that it's not bad and the person who does that should be punished. And so I always find that myth kind of plays out over and over again in all these discussions about regulation. That this stuff, you know.

• 40:40Vijay Pande?

  Especially it's the gods who punish it, right? The existing gods.

• 40:42Marc Andreessen?

  Yes. Yes. Well, on behalf, on behalf of, on behalf of, uh, yeah, behalf of existence. But, um. Yeah. So, um, I, yeah, I, I think generally it's this, it's, it's just you get, you get these fears. If you look at the history of, you know, we, we talked about some of this. If you look at the history of new technologies, they generally have these fears.

• 40:58Vijay Pande?

  Yes.

• 40:58Marc Andreessen?

  Uh, every step along the way, if this technology's been created with some prediction that it's going to upend the social order and cause the, you know.

• 41:04Vijay Pande?

  Well, it does upend to some degree.

• 41:06Marc Andreessen?

  It will do that, but, but generally speaking.

• 41:08Vijay Pande?

  In a positive way.

• 41:09Marc Andreessen?

  On balance.

• 41:09Vijay Pande?

  Yeah.

• 41:10Marc Andreessen?

  You know, tech, I mean, technology is why we live much better lives today.

• 41:12Vijay Pande?

  Certainly people now would not want what people had 50 years ago.

• 41:16Marc Andreessen?

  Nobody would make that.

• 41:17Vijay Pande?

  Yes.

• 41:18Marc Andreessen?

  Right. And you could do, you could go back in time infinitum and be like that.

• 41:21Vijay Pande?

  Nobody would ever make that trade.

• 41:22Marc Andreessen?

  Yes. Nobody would ever make a trade to go back in time. It never happened.

• 41:24Vijay Pande?

  Yeah.

• 41:24Marc Andreessen?

  And it's, uh, yeah, right. That's literally, it's because you would not want to, you would not want to lose the technologies that, that, uh, you have today. So. I think that's true. And so I actually think like fear may be the, just for FDR, fear, fear may be the actual biggest threat.

• 41:36Vijay Pande?

  Yeah.

• 41:37Marc Andreessen?

  Fear leads to the kind of, uh, you know, reach for regulation.

• 41:40Vijay Pande?

  Yes.

• 41:40Marc Andreessen?

  I'm a skeptic. I, I don't, it's like, I don't know, right? Regulating math. Are we really going to regulate math?

• 41:47Vijay Pande?

  Well, but it's not going to look like regulating math, right? It's going to look like regulating this superpower.

• 41:51Marc Andreessen?

  That's what they're going to say.

• 41:52Vijay Pande?

  Yeah.

• 41:52Marc Andreessen?

  Right. But then the actual implementation.

• 41:54Vijay Pande?

  Yes.

• 41:54Marc Andreessen?

  Is, you know, risk.

• 41:55Vijay Pande?

  Regular nature, Galsbr.

• 41:57Marc Andreessen?

  Yeah, regulating algebra, regulating linear algebra. Like, are we really gonna regulate linear algebra, matrix multiplication?

• 42:03Vijay Pande?

  Yeah, really, seriously.

• 42:04Marc Andreessen?

  Yeah. And, and, and then even if we do, are we gonna possibly do it in a, in a way that makes any sense?

• 42:10Vijay Pande?

  Yeah. Well, okay, but it won't, obviously it won't look like that. It'll be saying, well, we can't have computer-driven cars.

• 42:16Marc Andreessen?

  Right.

• 42:16Vijay Pande?

  Or, like, what, what, what's, what's, how do you give the computer a test?

• 42:20Marc Andreessen?

  Yeah.

• 42:20Vijay Pande?

  Or how do you know, like, okay, you make this, I'll be the cynic, so, okay, you make this claim that the computer AI is better than human, like, how do I know that?

• 42:27Marc Andreessen?

  Because that, well, yes, it turns out, because the cars are driving.

• 42:30Vijay Pande?

  Yeah.

• 42:30Marc Andreessen?

  So, yeah.

• 42:31Vijay Pande?

  So, there, it's okay, so.

• 42:33Marc Andreessen?

  Yeah.

• 42:33Vijay Pande?

  Here was, okay, so here's how that played out in self-driving cars.

• 42:35Marc Andreessen?

  Yes.

• 42:35Vijay Pande?

  There was one category of company that said, we're gonna basically wait till it's perfect, and it's in a basically, from the melody, we're gonna work with the regulators, we're gonna build that stuff.

• 42:41Marc Andreessen?

  Yes.

• 42:42Vijay Pande?

  They're not driving.

• 42:43Marc Andreessen?

  And they're not on the road. They're still not on the road. Um, there's another category of company that said, you know what, let's evolve out of, basically, the cruise control. Um, and, you know, it's sort of cruise control, and then it's radar.

• 42:54Vijay Pande?

  And, and you get humans driving with it, and you label data, and.

• 42:57Marc Andreessen?

  Exactly. And you don't expect the car to drive itself in, in, for the very beginning. The, the car is like an autopilot kind of thing. The expectation is you pay attention, like, you know, Tes- Tesla's the company I'm alluding to. And if you, if you turn on full self-driving in a Tesla, you're still, you know, you're still told, like, you're not supposed to be watching a movie, you're supposed to be actually paying attention, and the car will, like, alert you when it's time to pay attention. Um, but, you know, notwithstanding that, Tesla has been climbing the ladder on self-driving car functionality capability. They do new software releases, push live car at night, anytime they want. Those new releases are not being tested by.

• 43:26Vijay Pande?

  Yeah, yeah.

• 43:27Marc Andreessen?

  You know, it's, uh, whatever, it's not, any of these things.

• 43:30Vijay Pande?

  Yeah.

• 43:31Marc Andreessen?

  There's no actual test happening.

• 43:32Vijay Pande?

  Yeah.

• 43:32Marc Andreessen?

  Uh, and that has, and that has led to incredible progress, including.

• 43:36Vijay Pande?

  Yeah.

• 43:36Marc Andreessen?

  As you said, clearly in the data, this is now.

• 43:38Vijay Pande?

  Because you can't, drivers, you can't make it work just magically, right? It has to do, happen gradually.

• 43:43Marc Andreessen?

  Right, because it's, it's, yeah, it's actually much like medicine, is it's entering into a complex system, a lot of variables.

• 43:48Vijay Pande?

  Yeah.

• 43:49Marc Andreessen?

  In the real world.

• 43:49Vijay Pande?

  Like medicine too, it's like life or death. You know, it's just serious.

• 43:53Marc Andreessen?

  But, yeah, but, yeah, then we go back to how we started the conversation.

• 43:56Vijay Pande?

  Yeah.

• 43:57Marc Andreessen?

  The, the wait for permission thing, the, the binary zero or one, wait for permission, wait for perfection thing, versus the incremental, let's get better and better and better, and the threshold is, is it better than humans? Is it, is it, is it an improvement? I mean, clearly in self-driving cars, that second approach is the approach that's working. Have you just, you know, observe, observe.

• 44:14Vijay Pande?

  And you think you get to the tipping point where, look, let's look at the statistics. We have, because we have all this happening right now. We have the statistics and it's like so much better than humans. Why wouldn't we do it?

• 44:24Marc Andreessen?

  Yeah, exactly right. And then at some point, the morality tips where it's like, well, obviously we have to go in this direction. Because it's just obviously better.

• 44:29Vijay Pande?

  Yeah.

• 44:30Marc Andreessen?

  I suspect we're going to get their medicine pretty quick.

• 44:32Vijay Pande?

  Yeah, yeah, yeah.

• 44:33Marc Andreessen?

  I'm an optimist on that. And again, I'm not an optimist because I think the AI is going to be perfect. I'm an optimist because I think the status quo is not that good.

• 44:39Vijay Pande?

  Yeah, yeah. Well, that might be like you start empowering doctors, you give them tools, they start using them. And you start empowering patients. Patients start using them. And actually here, I think it's even different than a car because you're not on a road. It's in your body or whatever. And actually, patients are driving their own healthcare more than ever. I think COVID was another sort of tailwind there. So maybe you start, maybe it's just about developing the tools and giving them out.

• 45:00Marc Andreessen?

  Well, here would be an example. So let's use our screenwriting app to plug in the medicine, which is, you know, any given set of conditions. There may be many possible diagnoses. An experience I've had is there's a set of, a set of symptoms.

• 45:10Vijay Pande?

  Yes.

• 45:11Marc Andreessen?

  One doctor comes up with a diagnosis. Another doctor comes up with a different diagnosis. You read the literature and it's like, actually, both of those diagnoses in theory are. But like, for some reason, the one guy only thought of the one, the other guy only thought of the other.

• 45:20Vijay Pande?

  Yeah.

• 45:20Marc Andreessen?

  So a way for doctors to start using this technology today would be plug in the symptoms. Give me five possible diagnoses.

• 45:26Vijay Pande?

  Yes.

• 45:26Marc Andreessen?

  Okay, oh, I didn't even realize, right, that, you know, because maybe this is a new thing since, you know, I went to medical school or something. I didn't even realize diagnosis number three was an option. I have to go look at that.

• 45:34Vijay Pande?

  Yes, yes.

• 45:35Marc Andreessen?

  Right, and so the doctor is still doing the diagnosis.

• 45:37Vijay Pande?

  It's your screenplay example.

• 45:39Marc Andreessen?

  Yeah, your augment, as a doctor, your augment. Because AI in that case is luring you to things that you should know, but you don't know.

• 45:44Vijay Pande?

  Yeah, yeah. I mean, that's interesting. It's almost like having a mentor or, or just someone to riff with.

• 45:50Marc Andreessen?

  That's right.

• 45:51Vijay Pande?

  Yeah, yeah, yeah.

• 45:52Marc Andreessen?

  And they're right, it's great thing is it is a machine. It riff with you as much as it wants. And like, you know, sit there at three in the morning, yeah, it has a hundred times for you. It's happy to, it doesn't get bored, it doesn't get tired.

• 46:00Vijay Pande?

  Yes.

• 46:00Marc Andreessen?

  By the way, and then it also has the advantage, it has all the up-to-date information.

• 46:03Vijay Pande?

  Yes, yes. And all the outcomes. And when it makes a mistake, it actually can learn from it, whether actually from being, other than being like devastated by it or emotionally reacting to it.

• 46:13Marc Andreessen?

  Right, right. Right, and like self-driving cars, if it makes, if some other doctor in some other state had a patient last week and made a mistake and they fixed the mistake. It will not make the mistake again, your patient.

• 46:21Vijay Pande?

  Yeah, yeah. Yeah, so I mean, so you think, and so that is a very different regulatory play that we've seen in the history of healthcare.

• 46:29Marc Andreessen?

  Well, I think that's just, well, you tell me, I think that's just gonna happen. So here's what everybody knows. I'll give you a couple of things that everybody knows. Everybody knows that patients should not be on Google.

• 46:37Vijay Pande?

  Yes.

• 46:38Marc Andreessen?

  Everybody knows every patient now does that.

• 46:40Vijay Pande?

  It's called Dr. Google. Literally how it's called in the field.

• 46:44Marc Andreessen?

  Right, and there's no way, like, you're not practically speaking, to like, regulate that out of these.

• 46:47Vijay Pande?

  Yeah, yeah, yeah.

• 46:48Marc Andreessen?

  That's gonna happen. I, I, I think doctors using these new tools as augment is something that they can just do. It doesn't require approval.

• 46:54Vijay Pande?

  So the ship is already sailed.

• 46:55Marc Andreessen?

  I think so. And by the way, patients using GPT, if it hasn't started, it's gonna start immediately. Yeah, yeah, probably. And so, so, so the patients are going to show up with the results of GPT queries, and the doctors are going to have to respond to that. And so they're gonna end up being in this world whether they wanna be or not.

• 47:07Vijay Pande?

  But that's actually really interesting, because as a patient, and I probably know just enough about medicine to be dangerous to myself, but like, I show up with the doctor and I have all of that thought out, basically that might equalize the patients. You know, such that they can actually come much more educated and come from much more thoughtful, and they become much more in the process as well. Yeah. Okay, so what goes wrong?

• 47:27Marc Andreessen?

  Double-edged sword. I mean, you, as a doctor, do you want your patient?

• 47:29Vijay Pande?

  Yeah.

• 47:30Marc Andreessen?

  Do you want your patient more educated or less educated?

• 47:32Vijay Pande?

  They may just be humaning me, but I think they want.

• 47:34Marc Andreessen?

  Maybe with you, they are educated. With me, they might look a little bit more sideways.

• 47:39Vijay Pande?

  Actually, but if it was really helpful, I think they would. I, I think it's just about how good it is, right? Okay, so what goes wrong? Like?

• 47:46Marc Andreessen?

  I mean, look, then the big thing that goes, I mean, look, the big thing, I think two things go wrong. So one is just the expectation of perfection. Right? And, and look, it's very, you know, it's, it's very easy to generate the negative headline. It's very easy to set off the scare, the moral panic, basically. Right? If a single essence goes wrong and it gets extrapolated, you know, we talk a lot about phletamide, like, you know, it'd be very easy to have that kind of moment.

• 48:06Vijay Pande?

  Or like the, the, the person on a bike that got hit by a Tesla or something like that. I think it was biking across a freeway.

• 48:14Marc Andreessen?

  Right.

• 48:15Vijay Pande?

  And so like, a human probably.

• 48:17Marc Andreessen?

  Hit them too. Yeah, that's right. Yeah. Oh, that's a good point. Yeah, yeah, yeah. The trolley problem. Yeah, yeah. You know, the trolley problem's been in the press a little more recently. It has a chance out that Seth Maitman Free was an expert in the trolley problem. Okay. Shows you that it's not the route. How it is. Yes. As it's been marketed marketed. But, um, yeah, the trolley problem, the problem always gets mooted. The trolley problem gets always mooted about who's driving cars, which is, you know, you have a choice between killing. You know, I don't know. It's like, I don't know, five grandmas or one little kid or you know, all these different like you have to pull. Pull the lever in the side, but but like you would drivers don't. No, no, no. Drivers never make that decision. No, they have gas or brake. Yes. Right. And they have, I'm gonna hit the car in front of me. Yeah, not yet. Hit the car in front of me. It's never this elaborate thing. It's always a very simple thing.

• 48:57Marc Andreessen?

  And so it's not a question of whether the machine can ideally solve this sort of, you know, idealized complex problem. It's can it hit the brakes faster, right? When it's about to crash in the car directly in front of it. And so properly logically kind of containing the expectation here to actual real world. And not having this spin off into these like basically fantasy narratives that you can then criticize. Um, yeah, the, the, the, yeah, so that the absolute, the absolute limits. Um, and then, yeah, look, I, I think just the generalized fear, right? And what I always have to remind myself is like, you know, I'm like, say, I was on the software, software developer. My background is like, okay, I can actually like the algorithms that do this, like, you know, can I tell you every aspect of how they work? No, like, do they, do I understand how they work? Do I understand the basic foundations? Do I understand the basic math? Yes. This is why I make the comment about regulating math. Yes.

• 49:41Marc Andreessen?

  Now, to somebody who's not a coder, right? This whole, this all this stuff. It's weird. It's like weird math. Yeah. Right. Um, yeah. And so there is a. Yeah. I have to remind myself to be patient and tolerant of people who don't understand the mechanics of what's happening. That said, I think the people who are gonna be, I think they also have to get in the mechanics and try to understand us. And that, and there's always slippage there. Yeah. So what's the antidote to fear? Is it optimism? Is it education? I mean, ideal, ideally, I mean, I think there's that ideally, it's, yeah, ideally, it's cultural, uh, cultural orientation towards new technology. And then ideally, it's, it's education and people learning and kind of, um, or, you know, the C P snow to cultures. Yes. Yes. Yeah. From that grass coming together and kind of educating each other. Honestly, a big part of it also, I think, is when things become a fated company. Yeah. I mean, this is what Tesla's done with self-driving cars. Yeah.

• 50:26Marc Andreessen?

  Like, if it's just happening. Yeah, yeah. Right? Because who would want to go back? Like, you want to go back. Like, the system adapts. Right. And so there was this famous, Uber fought all these regulatory wars and all the cities that they ran because it was not technically allowed under taxi limo charges in the beginning. So one of the things they did early on was they just made sure that there were always lots of Uber cars available around state houses and city halls. Yeah. And so whenever somebody, you know, so you'd literally have somebody who's like in, you know, sort of giving this like roaring speech, you know, in city hall about shutting down Uber. And then they would come out and they'd have to get home really fast. And Uber would show up 20 seconds later. Right. It's like, at some point, it just was like taken for granted. And then at that point, if you just said literally, are we going to take Uber away? People would have said, no, we can't. It's over. And that's what happened. And then, and then literally what happened is they changed the laws to accommodate that behavior.

• 51:11Marc Andreessen?

  And so I actually think part of it here is just like having these tools. Okay, here's a thing, here's a good news thing. These tools are becoming widely available upfront, right? So like 50 years ago, a new technology like this would have been like deployed in the government first and then into companies, and then years later in the form of something individual people could use. The model today is like, it's just online. Yeah. Like, GPT is online right now. Yes. Well, the future paint is really intriguing because from an engineer point of view, it's the engineer's dream that if we make it good enough such that it can get to a point where people just love it and it's helpful and it does what it needs to do, the rest will take care of itself. Yeah. I mean, I kind of think that's mostly how things are. I mean. Yeah. Yeah. Well, it's a beautiful feature. Yeah. Yeah. So now, look, having said that, healthcare is very sophisticated, right?

• 51:55Marc Andreessen?

  There's lots of regulations, there's lots of payment, right? All these things. So I saw this thing on Twitter the other day. Yeah, yeah. Blew my mind, right? Because this whole time I've been thinking in terms of like, you know, diagnosis and this stuff in my life. So this doctor posted a video, and I think I saw that one. You always saw this. So that person video, and he said, look, he said, the problem is whatever diagnosis, so whatever, like, I do the diagnosis, I do the prescription. Then it's a question of whether or not I can get the insurance company to reimburse and to pay for the thing. To do that for anything even slightly out of the ordinary, I have to write a le- I, the doctor, has to write a letter to the insurance company and that letter needs to be in a specific format and it needs to-

• 52:28Vijay Pande?

  To make the case, right?

• 52:29Marc Andreessen?

  Make the case and it needs to have the scientific citations.

• 52:31Vijay Pande?

  Yeah.

• 52:31Marc Andreessen?

  And if I do the letter really well, it's gonna get paid for it. If I don't do the letter really well, it's not gonna get paid for it. It's gonna matter, you know, to the possibility of the life of the patient.

• 52:38Vijay Pande?

  Yes.

• 52:39Marc Andreessen?

  Um, and so he's like, it turns out GPT is really good at writing those letters.

• 52:42Vijay Pande?

  With the references.

• 52:43Marc Andreessen?

  With the references, yes. With the scientific references, like, full on, right?

• 52:47Vijay Pande?

  Yeah.

• 52:47Marc Andreessen?

  And so you've got this, so that's another way to think about it, is you've got this bureaucratic process-

• 52:51Vijay Pande?

  Yeah.

• 52:52Marc Andreessen?

  Which is legitimate and required and yet to exist. And that data needs to be submitted and honestly, it does not matter to that process whether that document is written by human or machine.

• 53:00Vijay Pande?

  Yeah, yeah, yeah.

• 53:00Marc Andreessen?

  But all of a sudden, if every doctor in the world is really good at writing correctly, properly-

• 53:04Vijay Pande?

  Yes.

• 53:05Marc Andreessen?

  Letters, then all of a sudden, it goes to the thing. All of a sudden, that doctor now is now, you know, whatever, four hours a week to-

• 53:09Vijay Pande?

  Yeah.

• 53:09Marc Andreessen?

  Take care of patients.

• 53:10Vijay Pande?

  Yeah.

• 53:11Marc Andreessen?

  Like, that's the kind of thing that I think is gonna happen more directly. And that, what's interesting, what's interesting about that example is you can imagine that example having a big impact on the efficiency of the healthcare system today.

• 53:19Vijay Pande?

  Yes.

• 53:19Marc Andreessen?

  Without any regulatory changes.

• 53:20Vijay Pande?

  Yes, without, oh, it's within the system.

• 53:22Marc Andreessen?

  Within the system, actually, within the system.

• 53:24Vijay Pande?

  Yeah.

• 53:24Marc Andreessen?

  And so, and that was just, and that was the one where it's just like, oh, in retrospect, that's obvious. I just haven't thought about it.

• 53:30Vijay Pande?

  Yeah.

• 53:30Marc Andreessen?

  One guy thinks about it, all the other doctors start to do that. The whole system upgrades, sub-function, you know, one time.

• 53:35Vijay Pande?

  Yeah.

• 53:36Marc Andreessen?

  I, I think that kind of thing, I think, is a real possibility.

• 53:38Vijay Pande?

  Yeah, and that could be because if someone's working within the system, you can have the transformation immediately. But then eventually someone has to read all those letters. Someone has to validate them. It's probably, you know, some sort of NLP on the other side.

• 53:49Marc Andreessen?

  Well, that's right. It's, it's corresponding. So there's, we have this company, um, uh, this company called Do Not Pay.

• 53:54Vijay Pande?

  Yeah.

• 53:54Marc Andreessen?

  Um, yeah, it's just this company, it's a, it's an, it's an app that sort of acts like a bot and-

• 53:58Vijay Pande?

  Yeah, no, I've used the app, it's for, it's for people that people-

• 54:00Marc Andreessen?

  That's right. It's, and it basically, it'll basically get you, it started to get you like out of, it was starting to get you out of like basically, um, uh, fake, uh, sort of BS traffic tales. Um, and then, um, it's, he real, he did this thing a while ago where it will unsubscribe you for, you know, all these consumer subscription services like Comcast or whatever, like, they all make it hard to like ever turn off the subscription and so- He has this way to, the, the bot will do it for you. And so he just started using AI in the bot and so, um, he now- So, so the way a lot of consumer subscription companies work is you can't, you can subscribe online, you can't actually unsubscribe online. You have to call any number and you have to argue with a person. And there's actually this thing in these companies called save teams- Where they're actually paid specifically to prevent you from unsubscribing. And they'll try to cut special deals with you and they'll try to talk you out of it.

• 54:41Marc Andreessen?

  And so he has this thing wired up where now he has the, he has AI-generated text with, with then text to speech.

• 54:47Vijay Pande?

  Oh, it's just talking.

• 54:48Marc Andreessen?

  And it talks, it talks, it talks to the customer service person at the line.

• 54:52Vijay Pande?

  Yeah.

• 54:52Marc Andreessen?

  And it basically, with infinite patience.

• 54:54Vijay Pande?

  Yes.

• 54:56Marc Andreessen?

  And so it will just sit and it will just argue like, no, I am actually going to subscribe for, yes, no, I'm not running such a special offer.

• 55:03Vijay Pande?

  No, no, no, no, no.

• 55:05Marc Andreessen?

  Exactly. Until finally the other guy gives up and says, okay, fine, I'll stop charging you. And so it's like, okay, you know, it was, it was a precondition of the system that that worked the way that it did. It was a burden on people to have to deal with that. AI can now step in and equalize the power imbalance between the customer and the company.

• 55:23Vijay Pande?

  And presumably that will change the system.

• 55:25Marc Andreessen?

  Yeah, well, one would think, well, it would help, right? And to your point, like, step one for changing the system might mean retaliation, which is all of a sudden the save teams will be bots. And so maybe the bots will be arguing with the bots. But at least it gets you out of this kind of Kafkaesque thing you're in today where when you deal with these big companies, you're dealing with this giant, you're, you're individually dealing with a giant bureaucracy. At least it like equalizes the power.

• 55:44Vijay Pande?

  Well, that's kind of amazing. And that will be the spark for changing things. Because once you're in that sort of system, like, we got to do better than this.

• 55:50Marc Andreessen?

  Yeah, this is crazy. You're saying bots argue with each other all day long is just clearly stupid.

• 55:54Vijay Pande?

  Yeah, yeah, yeah, yeah. And especially when there's bots on both sides, now we can finally say, well, let's do an API on both sides. So let's do something smart on both sides.

• 56:00Marc Andreessen?

  Yeah.

• 56:00Vijay Pande?

  Just kind of, yeah.

• 56:01Marc Andreessen?

  Yeah.

• 56:02Vijay Pande?

  Well, Mark, I mean, that's such a sort of beautiful, optimistic view of how this could go, right? Because the future we're talking about is actually much more engineer-driven that if an engineer can build this, and it really, really works, it really helps patients, it really changes things. It'll get adopted. As it gets adopted, culture will work around it and will love it and will, I want to go back. And then the future will just be right in front of us.

• 56:28Marc Andreessen?

  Yeah. I mean, look, patients are going to get a vote.

• 56:30Vijay Pande?

  Yes.

• 56:30Marc Andreessen?

  Doctors are going to get a vote.

• 56:32Vijay Pande?

  Right, yeah.

• 56:32Marc Andreessen?

  And, you know, this, yeah, look, it's an, it's an industry made up of people, a world made up of people, people will get a vote.

• 56:37Vijay Pande?

  Yeah, beautiful. Thank you so much for joining.

• 56:45Speaker 01

  Thank you for joining BioEats World. BioEats World is hosted and produced by me, Olivia Webb, with the help of the Bio and Health team at A16Z and edited by Phil Hegseth. BioEats World is part of the A16Z Podcast Network. If you have questions about the episode or want to suggest topics for a future episode, please email [email protected]. Last but not least, if you're enjoying BioEats World, please leave us a rating and review wherever you listen to podcasts. Please note that the content, for informational purposes only, should not be taken as legal, business, tax, or investment advice, or be used to evaluate any investment or security, and is not directed at any investors or potential investors in any A16Z fund. For more details, please see as16z.com/disclosures.